Second global COVID-19 wave offers valuable lessons for Vietnam: Politburo member

Seeing the world struggle with the second coronavirus wave could offer valuable lessons for Vietnam in flattening the curve as the country has also been hit by a second wave of COVID-19 infections.

Politburo member and Secretary of the Ho Chi Minh City Party Committee Nguyen Thien Nhan (second from left) visits a face mask production site at Thong Nhat Hospital. (Photo: Sai Gon Giai Phong)
Politburo member and Secretary of the Ho Chi Minh City Party Committee Nguyen Thien Nhan (second from left) visits a face mask production site at Thong Nhat Hospital. (Photo: Sai Gon Giai Phong)

The statement was made by Politburo member and Secretary of the Ho Chi Minh City Municipal Party Committee, Nguyen Thien Nhan, in his recent article sent to Nhan Dan Newspaper.

Nhan assessed that the COVID-19 epidemic is spreading strongly globally and in different continents at different rates and in diverse stages. Since the first outbreak in China last January, the pandemic has spread to over 213 countries and territories, with an unprecedented scale and speed.

On January 10, the world recorded the first person as having died of COVID-19 in Wuhan (China). On April 2, 204 countries were hit with COVID-19, with 1 million infected and around 53,100 deaths. Three months later, on July 3, the number of people infected with COVID-19 was up to 11 million and the number of deaths had risen to 532,800. In mid-August, there are over 21 million people infected with COVID-19 around the world.

The new strain of the coronavirus (SARS-CoV-2) took 92 days to spread to the first million infected people worldwide, but only needed another 13 days to spread to another 1 million, and now within every four days, 1 million people are newly infected with COVID-19 across the world.

According to Nhan, after the world reached the peak of the first coronavirus wave, many countries around the globe have been hit in turn by a second wave with a higher infection rate and a rapid spread whose peak is difficult to predict.

The Ho Chi Minh City senior leader said that a common feature in countries hit by the second wave of COVID-19 is that after they reached a supposed safety threshold once the first wave reached an apparent peak, they eased social distancing and reopened trading activities with the world, thereby allowing the coronavirus to peak again, leading to a second wave of infections, in countries such as Australia, Japan, Hongkong (China) and Israel.

Amid its strong spread in America, Europe and Asia, there has been no indication of when the pandemic will reach its peak for a second time and when it will arrive at some sort of safety threshold, Nhan said.

In Vietnam, with a population of 96.5 million people, the safety threshold is 970 patients receiving simultaneous treatment. Since the first positive case was confirmed on January 23, at the highest peak of the outbreak in Vietnam, only 178 patients were receiving treatment at once, then this number gradually decreased. That means Vietnam’s first infectious wave reached its peak on March 30, but the country was not in a widespread pandemic state, according to the Politburo member.

On June 18, there were only 10 infected patients being treated in hospitals nationwide. However, after more than a month, from July 22, the number of new infections increased sharply. On August 7, 384 patients were undergoing treatment, 2.16 times higher than that at the peak of the first wave, marking Vietnam as having entered its second wave of infections.

After 190 days with COVID-19 infection but without any deaths, within 11 days, from July 31 to 21:00 on August 10, 14 people died. Currently, it is unclear when the second wave of COVID-19 infections in Vietnam will reach its peak. With the total number of infections as of August 10 at 847, it is possible that between August 15 and 20, Vietnam is likely to reach the 1,000 infection case mark, with about 500 COVID-19 patients receiving treatment simultaneously at hospitals nationwide. That means the total number of infected people being treated is at almost three times higher than that during the peak in the first wave, with 10 people having died in just seven days. The second wave of COVID-19 infection in Vietnam may be much more serious than the first, Secretary Nhan analysed.

From the developments of the 2nd COVID-19 wave in Japan, Hong Kong (China), Australia and Israel, it can be seen that at the end of the first wave, even though the number of patients receiving treatment in such countries had decreased but has not yet reached its epidemic safety threshold, Australia and Israel have loosened their social distancing measures and reopened social and service activities, leading to new outbreaks again. The infection source is mainly currently infected people living in such countries.

Meanwhile, in Japan and Hong Kong (China), at the end of the first wave, although the number of infected people was small and below the safety threshold, the second wave of infections has come as the result of loosening epidemic control measures (such as not wearing face masks), allowing crowded gatherings (reopening schools, allowing demonstrations), resuming social services or being infected by foreigners entering the country (US troops stationed in Japan).

Vietnam has controlled infection in the community very well, due to timely detection of infected cases returning home from abroad as well as other close contacts from within the country, combined with thorough isolation of all related cases. Other preventive measures such as wearing of face masks, practicing social distancing and disinfecting have helped in keeping the number of infections needing treatment very low. Before July 20, Vietnam had passed nearly 100 days without any infections in the community, while citizens repatriated from abroad have always been isolated immediately upon entry to keep the community safe.

According to Nhan, from July 22, a series of infections detected in Da Nang, spreading to other localities from there, means that the source of infection for the Da Nang outbreak must be from abroad, through illegal road entry, as in July 2020, in Da Nang and Ho Chi Minh City, hundreds of illegal entries from a foreign country badly hit by COVID-19 were found. This was a completely different factor from the first wave of COVID-19 infection. Uncontrolled foreign infection sources breaking into Vietnam has resulted in a series of their close contacts testing positive for the coronavirus and thus leading to a new outbreak in Vietnam from July 22 to the present, Nhan stated.

The second wave of COVID-19 infections in Vietnam, with its epicentre at Da Nang, is of huge difference in size and nature compared to the first wave, he said. After only 17 days, the number of new infections requiring treatment was 384, more than twice as high as the first epidemic peak of 178 cases and still not having reached its peak just yet. There were several related deaths, while no fatality was recorded before July 22. When the first wave peaked, only 178 patients needed treatment, at the rate of 1.8 per 1 million people, while this time, in Da Nang, this rate is 150 per 1 million people, 15 times higher than the safety threshold of 10 patients needing treatment per 1 million people.

However, on a national scale and in comparison with epidemic developments in other countries, Vietnam is still with a very low level of COVID-19 infection, Politburo member Nhan wrote. The infection rate among the community in Vietnam is 9 per 1 million people, less than half of that when the World Health Organisation (WHO) announced COVID-19 outbreak a global pandemic on March 11, while it is also small in comparison with other continents’ infection rates ranging from 550-10,000 cases per 1 million people. With the current rate of treatment at 4.5 patients per 1 million people, the infectious status in Vietnam is only about half of the world's when the epidemic was announced (10 patients need treatment per a million people). In terms of the death rate per 1 million people, Vietnam is at 0.12, very low compared to the world on March 11 (0.6 deaths per 1 million people). In general, Vietnam has a very low level of infection compared to the world and is not a country with a massive COVID-19 outbreak.

However, as Vietnam entered its second wave of infection, from July 22, the situation was very different as a new epidemic epicentre has formed in the Quang Nam - Da Nang area. With 132 infected cases per 1 million people, 124 patients being treated in hospitals per million people, and the death rate is 4.16 deaths per 1 million people, Quang Nam - Da Nang has become a real epidemic centre. The rate of infected cases per a million people is 6.5 times higher than the rate when the WHO announced the epidemic, while the rate of patients being treated per 1 million people was 12 times higher and the death rate per 1 million people was nearly seven times higher. The number of COVID-19 patients being treated in Quang Nam - Da Nang accounts for 75% of the country's total (327/435), while the number of deaths accounts for 100%.

While Vietnam has not had a widespread COVID-19 outbreak yet, Quang Nam - Da Nang is already an epicentre with a relatively high level of infection. This situation did not occur in the first COVID-19 wave in Vietnam, Nhan said, adding that to stamp out the outbreak in Quang Nam - Da Nang and continue to keep Vietnam as a country free of COVID-19, anti-epidemic attitudes and methods to cope with the outbreaks in Quang Nam - Da Nang and other localities must be added to those from the first wave of infection.

From January, the Party and Government have given timely and drastic instructions and the local people and authorities have strongly responded. These are very valuable lessons that need to be learned, Nhan said, pointing to the results of epidemic prevention and control in Hong Kong (China), Israel and Cambodia – those have had passed the peak of their second infection wave.

In can be seen that the period from the peak in the first wave to that in the second infection wave is about 3.5-4 months, but in countries that have not yet reached the peak of the second wave, like Japan and Australia, the period has passed the 3.5-4 month mark since the peak of the first wave. Vietnam has passed more than four months now since the first wave’s peak on March 30. For that reason, if Vietnam extinguishes the outbreak in Quang Nam - Da Nang and prevents any new outbreaks in other localities, in about two to three weeks, the country could significantly avoid infection in the community, as the second wave is predicted to reach its peak in around late August to early September. Thereafter, the rate of infection will likely decrease, according to Nhan.

From the lessons learned in Vietnam's successful COVID-19 fight before July 2020 and both the successes and failures of epidemic prevention and control in other countries, Nhan stated that Vietnam can completely stamp out the current outbreak in Quang Nam - Da Nang and successfully implement epidemic prevention in other localities.

He also suggested some solutions to boost the COVID-19 fight in Vietnam, with the first being focusing on early epidemic prevention, timely detection of new infections, complete isolation and effective treatment. The second is making use of on-the-spot forces and resources. The third is promoting the unity and synergy of the community in unison with the direction the Party leads and State leads, directs and takes responsibility, while the whole political system takes part in bringing into play the Vietnamese tradition of solidarity, compassion and resilience in the fight against COVID-19, and each citizen is a soldier, each family is a fighting team and each district is a solid fortress for the prevention of and fight against the pandemic.

Accordingly, Nhan clarified some current on-site tasks in detail, including stamping out the outbreak in Quang Nam - Da Nang, isolating Quang Nam - Da Nang from other localities for the next two to three weeks, and strictly controlling Vietnam's road border to prevent any illegal entry in the next six months.

As those with a high epidemic risk, localities bordering Quang Nam - Da Nang (including Thua Thien Hue, Kon Tum and Quang Ngai) were suggested to implement appropriate solutions. Other provinces and cities, depending on their level of interaction with Quang Nam - Da Nang in the last month, should deploy appropriate measures to prevent infection according to the three aforesaid principles of epidemic prevention.

The Ministry of Health should act as a focal point for providing all medical equipment, supplies and drugs for epidemic prevention nationwide and relating to outbreak control in Quang Nam - Da Nang. The National Steering Committee for COVID-19 Prevention and Control should make a forecast of COVID-19 spread in the country every three days, while deciding on measures to be implemented across the country, in all sectors and all localities.